Business Request Form

Your Name (required)

Your Email (required)

Contact Number (required)

Where are you based? (required)
Province (required)

Town (required)

How many people live in your community or town? (required)

What is the average number of people per household? (required)

What is the average spend per household per month on electricity, coal, gas, wood and paraffin? (required)

What is your position in the community? (required)

Where did you hear of the 5 Star Clean Cooking Business? (required)

What is your motivation to become a business owner and have you conducted business on your own account before? (required)

Have you already identified waste biomass in your area? (required)

Have you managed people before? (required)

Do you have any previous criminal convictions or offences? (required)

Please motivate why you should be assisted to become a business owner? (required)